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. 2018 Mar 2;6:45. doi: 10.3389/fped.2018.00045

Table 2.

Termination of apnea.

Reference/study design Study objects Detection signals Stimulation characteristics DurationStimulation time Results of stimulation
Camargo et al. (22)
Observational study
4 infants
Gestational age (GA) inclusion: <36.6 weeks
Weight inclusion: <2,500 g
Pulse frequency by oximeter
Peripheral oxygen saturation (SpO2) by oximeter
Instrument: VBW32 skin transducer, audiological engineering
Location: thorax
Stimulus: 4 s, 250 Hz
Stimulation: 4 s Apnea (HR < 100 bpm, SpO2 < 80% for <35 weeks, HR < 80 bpm, SpO2 < 80% for >35 weeks):
Resumption of breathing in 9 of 10 apneic episodes

Pichardo et al. (19)
Randomized crossover study
4 infants
GA inclusion: >28 weeks
Weight inclusion: >1,000 g
Nasal airflow (AF)
HR by chest leads and saturation probe
SpO2
Electrocardiogram
Thoracic impedance
Mechanical
Instrument: VTS transducer VBW32, audiologic engineering
Location: thorax
Stimulus: not described
Manual
No specifications
Stimulation: 3 s
Mode switch: after 12 h or after 5 apneic attacks
Duration: 24 h
Repetitions: 2× for one infants
Apnea:
Similar effectiveness in ending apneic spells (p = 0.62)
Significant decrease in stimulus duration (p < 0.001)
Decrease in reaction time to apneic spell (p = 0.058)

Lovell et al. (23)
Randomized crossover study
1 infant
GA: 28 weeks
Weight: 1,280 g
Day start study: 7
Treatment: aminophylline, first 2 days on continuous positive airway pressure
Respiration rate
HR
SpO2
Mechanical
Instrument: model 1220 audiological engineering
Location: sole of the foot
Stimulus: 250 Hz square wave, impedance of 22 Ω (vts)
Manual
Location: trunk and extremities
Stimulus: gentle to vigorous stroking or shaking of the trunk and/or extremities (manual)
Stimulation: approximately 3 s
Mode switch: after 8 h
Duration: 16 h
Repetitions: three times after 2, 6, and 11 days
Apnea (>20 s or <20 s + bradycardia/intermittent hypoxia):
Similar effectiveness in ending apneic spells (p > 0.05)
Decrease in stimulation time of 3.9 s (p = 0.05)
Similar reaction time (p = 0.93)
Similar time to termination (p = 0.67)
Similar apnea duration (p = 0.94)

Frank et al. (24)
Observational study
4 infants
GA: 31.25 weeks
Weight: 1,495.5 g
All infants asleep
Respiration rate by impedance plethysmography Instrument: balloon with a towel.
Location: transversely under the neck
Stimulus: 4 psi pressure source, inflation in 0.5 s
Stimulation: 3 pulses Apnea (10 s, sometimes 5 or 15 s):
Resumption of breathing in 99 of the 105 apneic episodes